| NPI | 1417590910 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY L MULL Credentialing & Enrollment Director 570-271-6603 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 207XP3100X Orthopaedic Surgery Pediatric Orthopaedic Surgery |
| 207XS0106X Orthopaedic Surgery Hand Surgery | |
| 207XS0114X Orthopaedic Surgery Adult Reconstructive Orthopaedic Surgery | |
| 207XX0004X Orthopaedic Surgery Foot and Ankle Surgery | |
| 207XX0005X Orthopaedic Surgery Sports Medicine | |
| 207XX0801X Orthopaedic Surgery Orthopaedic Trauma | |
| 213E00000X Podiatrist | |
| 2251X0800X Physical Therapist Orthopedic | |
| Enumeration Date | 2019-10-28 |
| Last Update Date | 2019-10-28 |